Hungarian Veterinary Archive

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Title:

E. coli O104:H4 Serotype Outbreak in Germany in 2011

Author:

Leibbrand, Franziska

Date:

2013

Abstract:

From the first of May until the 25th of July of 2011 at 10 a.m. 852 cases of HUS, 3469 EHEC
cases including 426 asymptomatic EHEC infections were reported to the RKI. 32 HUS
patients and 18 persons infected with EHEC died. The outbreak was mainly localized in the
northern parts of Germany, in Hamburg, North Rhine-Westphalia, Lower Saxony, Schleswig-
Holstein and Bremen, although few cases have been reported in the neighboring countries and
the southern parts of Germany. The outbreak was declared to be ended on the 25th of July as
there were no new cases reported to the RKI for three ongoing weeks. For the clarification of
the responsible pathogen and the vehicle on which it was able to spread over such a great
distance a Task Force was formed.
The BGITech. discovered very quickly the serogroup O104 in an isolate from an stool sample.
Further investigations were based on this important fact. During the primary examinations
with the classical PCR the most important characteristic genetic information of the serotype
were found out. This information was used to develop a Multiplex-PCR; therefore the time
needed for the investigation of the sample decreased very rapidly. Simultaneously a very high
amount of samples of non human stool had to be handled. No technology was available for a
reliable isolation of the serotype in sample of ready-to-eat vegetables. So a faster and more
reliable method for the detection of EHEC/STEC of plant origin was developed. With the
help of these newly invented method they were able to isolate on a sprout of fenugreek the
serotype O104:H4. The positive predicted result by the forward and backward tracing of
fenugreek seeds could not be confirmed by microbiological methods. The forward and
backward tracing resulted in an high amount of data. A high coordination level of reported
new cases, analysis and visualization was needed to get a better overview. Paid and freely
available software was used and structures and databases already in use of the different
involved offices and organizations were employed. All these improved and new invented
materials and methods, are now available for an hopefully never coming future events.